 Poster: A snowHead
|
Hi, 8 weeks ago I had emergency surgery in Italy to insert a Philos plate after my humerus was broken in 4 pieces.
Once the NHS decided that I was ready for physio. it has been readily available at my local hospital- but only 15 minute appointments once a week.
This seemed fine when it started, as was very basic mobility exercises as any "aggressive" or painful movements were ruled out. I still have a couple of weeks to go before lifting more than a can of beans is allowed.
However, on the last couple of visits, she has done a couple of different "hands on" manipulations which seem to help free up the shoulder joint, increasing pain free ROM straight away.
So, should I now add some private physio to that which I am v grateful to be receiving on the NHS?
Thanks for any advice.
|
|
|
|
|
|
Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
|
@Helen M A, your first port of call for advice could be the physio who is treating you.
When I did my shoulder in, I was advised that having a lot of physio on shoulders was important to ensure the return of full rom, so I had a lot and it worked.
Good luck and welcome to snowheads.
|
|
|
|
|
|
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
|
@jbob, thanks for that - I did ask her and she reassured me that I was "doing well" - but I suspect that she finds it difficult to say that the NHS cannot give me the optimal amount of treatment !
Did you have a lot of hands on physio?
I am trying to do all the recommended exercises - nearly a full time job now that she's added very low weights...........
|
|
|
|
|
|
You need to Login to know who's really who.
You need to Login to know who's really who.
|
|
Yes, some hands on, some strapping, lots of exercises to do, and some posture advice. One of the things I found useful was advice to when it was right to push it when it was hurting. Apparently if you get frozen shoulder it's difficult to get shut of afterwards.
|
|
|
|
|
|
Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
|
@Helen M A, If your physio started to add weights, that's a sign that you can now do more exercise. I asked my physio that very same question and he said that a few shorter exercise sessions throughout the day were better than a long one (at that point I was exercising daily).
Your first priority should be regaining the full ROM. Once you've achieved that (or a possible maximum ROM), you can concentrate on strength exercises
|
|
|
|
|
|
You'll need to Register first of course.
You'll need to Register first of course.
|
| Helen M A wrote: |
Hi, 8 weeks ago I had emergency surgery in Italy to insert a Philos plate after my humerus was broken in 4 pieces.
Once the NHS decided that I was ready for physio. it has been readily available at my local hospital- but only 15 minute appointments once a week.
This seemed fine when it started, as was very basic mobility exercises as any "aggressive" or painful movements were ruled out. I still have a couple of weeks to go before lifting more than a can of beans is allowed.
However, on the last couple of visits, she has done a couple of different "hands on" manipulations which seem to help free up the shoulder joint, increasing pain free ROM straight away.
So, should I now add some private physio to that which I am v grateful to be receiving on the NHS?
Thanks for any advice. |
Shoulder fractures get very stiff, very quickly.
Get as much physio as you can afford.
If permitted by the surgeon consider even daily to start with. It will pay you back for the rest of your life!
Jonathan Bell
|
|
|
|
|
|
|
|
@snowglider, I have been trying to do my exercises 3 x a day since the sling came off at 4 weeks ago.
@Jonathan Bell, Thanks. Yes it is the fact that my entire shoulder still moves as I raise my arm that is worrying.
I never had pain in the joint , and virtually no post op pain around the bone, only in the sore and weak arm muscles.
So, we'll be in touch with BUPA on Monday !
|
|
|
|
|
|
|
|
@Helen M A, Yes, that should do it. If you can find the time, you could even throw in another session or two. They needn't be long; 5-10min each.
The important thing is to warm up the shoulder by gradually increasing the range of motion till you reach your current limit. Then GENTLY apply pressure to try and push past that limit and hold that position for about 10 seconds. Do about 3 of those "boundary - pushing" holds and that's it - your session is done (well, according to my physio); it worked for me.
The two exercises that I reaped the most benefits from were these: stand up with your back up against a wall. Bring your elbow (of the object arm) tight into your waist and against the the wall. Bend the elbow at 90° (as if to shake hands), so that your forearm is perpendicular to the wall.
Now grab hold of a brolly and with the object hand just grasp the handle. With the hand of your healthy arm grasp the shaft of the brolly and start pushing it, bringing the brolly across your stomach and rotating your injured upper arm i the shoulder. Your aim should be to eventally be able to touch the wall with the back of your forearm/hand.
*During this exercise it's important to not let your elbow flare out; it must remain burried at your side*
The second exercise is similar. Lie on the floor. Put your arm out to your side at 90°, so that your arm is perpendicular to your torso. Now bend your elbow at 90° (as if to wave at someone). Same thing again; use a brolly to push with the healthy arm onto the injured hand till the back of your hand/forearm are touching the floor.
*During both exercises let the arm of the injured shoulder remain passive; don't pull with it. Instead, use your healthy arm to push.
It won't happen overnight, so please be patient.
I'm not entirely sure I explained all of this well; please discuss it with your physio before doing it.
I know more exercises so if you're interested, please don't hesitate to ask.
I hope make a full recovery and get back on the slope before too long! 
|
|
|
|
|
|
You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
|
Well, after several weeks of the NHS physio seeming quite happy, and me seeing small improvements in what I can do most days, she tried more hands on stuff last week, and declared that the shoulder is frozen and that she can't free up the joint till it unfreezes !
Everything I read about a frozen shoulder says that it is a painful condition - my shoulder is still pain free until I push it further than it wants to go - there is no way I can move it behind my back for instance - but all the pain there comes in the arm muscles as far as I can tell.
Was she actually telling me that i have not been working hard enough myself? I'm now not sure whether to really push it , or just keep it moving till it frees up ..............
Cofused dot com is of no help ! 
|
|
|
|
|
|
|
|
| Helen M A wrote: |
Well, after several weeks of the NHS physio seeming quite happy, and me seeing small improvements in what I can do most days, she tried more hands on stuff last week, and declared that the shoulder is frozen and that she can't free up the joint till it unfreezes !
Everything I read about a frozen shoulder says that it is a painful condition - my shoulder is still pain free until I push it further than it wants to go - there is no way I can move it behind my back for instance - but all the pain there comes in the arm muscles as far as I can tell.
Was she actually telling me that i have not been working hard enough myself? I'm now not sure whether to really push it , or just keep it moving till it frees up ..............
Cofused dot com is of no help ! |
Frozen Shoulder is a diagnosis in its own right it comes on spontaneously.
Stiifness after surgery is secondary to the muscle inhibition, swelling and scar formation.
Progress will be slow.
|
|
|
|
|
|
snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
|
@Jonathan Bell, Thanks.
Yes, I saw a registrar yesterday as the consultant was "not in today" - she was confused by the advice that I had been given and went for a word with another consultant.
They confirmed that the bone has healed well - ( YIPPEE !  ) and that any problems are still post operative stiffness. As I can do a bit more every day I am not too worried and she gave me a letter foir the physio - and agreed that I should get extra privately too.
I shall soldier on ! Luckily I don't work at present and so have not had to spend hours at a desk, nor had to do a lot of cooking as my husband enjoys that. I did get around to cleaning the fridge yesterday though.
|
|
|
|
|
|
And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
|
|
The shoulder joint has the greatest range of motion out of all other joints in our body, which is why it is the joint most prone to injury....and re-injury. Be very careful during your recovery not to overdo it. I suggest slinging it anytime you aren't doing physio. It's also a good idea to put a cold compress on it after physio to get down any inflammation that might have developed.
|
|
|
|
|
|
|
|
Wel, the capsulitis is still here and the physios have given up on hard manipulation until it releases. The private physio resorted to acupunture last time and so I stopped and the NHS one said no point.
The fracture clinic said that the manipulation under anaesthetic is unsuitable with the plate in my arm and so that seems to be that for a while !
I keep lifting my weights for strength and stretch / push the movement with a pole for now.
I can do most day to day activities, but am desperate to clean the outside of our sash windows - stretching out and up whilst sitting on the windowsill - no chance of that for a while!
On top of all that I now have tennis elbow in the other arm (which has always been weak)
|
|
|
|
|
|
You know it makes sense.
|
|
Has anyone mentioned Hydrodilatation to you ? I had the same issue after breaking my shoulder, developing capsulitis. The consultant suggested a hydrodilatation injection to regain movement. The effect was almost instantaneous and after a couple of weeks I had regained probably close to 90% of ROM and with physio since it has been getting steadily better. Reckon I'm probably 95% of what I had before the fracture which happened in February. Although a lot of articles on the internet seem to suggest that it is quite a painful procedure I found it completely painless.
|
|
|
|
|
|
Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
|
|
To help increase mobility and and reduce the pain and stiffness, focus on things that increase the blood flow (but with minimal strain). I recommend treatments that don't require a lot of exertion in being able to do so. Things such as massage therapy, ultrasound, BFST, acupuncture, etc. These types of treatment give you the nutrients and oxygen you need to heal but reduce the risk factors involved with a lot of physical activity. It's also very important to follow anything physical with a cold compress. If the area is inflamed it hinders the blood flow even more than it would typically. Get the inflammation down, then increase the circulation. My recommendation - http://www.kingbrand.com/Shoulder-Home.php?REF=46PV134.276
|
|
|
|
|
|
Poster: A snowHead
|
I'm back again ! Have been somewhat distracted by my husband going into hospital and ending up having a quad. heart bypass op. , in the midst of which I twisted my ankle - but then found out it was a break - and I am still hobbling around with a weight bearing plaster & crutches.
Anyway, the arm is exactly as before - but with a little more discomfort from using the crutches - particularly when my leg plaster was non-weightbearing.
I went to the hospital a couple of days ago, and asked about the hydrodilitation. The consultant I am under prefers to do the manipulative version under GA, but agreed that I could be referred to the radiology dept. for the injection only type. There will be a six week (minimum?) wait on the NHS.
However, the junior doctor who was relaying this info. after going to see "the great man" [ why couldn't I just see him in the first place ? ] also threw in that he would prefer to take the plate out in any event.
As I have a fear of surgery, I was almost dismissive of this at the time - instead of asking "WHY ? " as I should have done.
Now, I am wondering whether I should have the philos plate taken out ? My shoulder x-ray is virtually identical to the left one here :
[url] https://uk.search.yahoo.com/search?fr=mcafee&type=B211GB0D20150625&p=philos+plate [/url]
Am I in danger of the screws & plate splitting the bone worse than ever if I fall on it again ? 
Perhaps I need to get a private appointment with a consultant to get a real discussion and advice ?
|
|
|
|
|
|
Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
|
|
If you were a horse........
|
|
|
|
|
|
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
|
|
....... I wouldn't have spent £250 on taxis visiting my husband in hospital because I couldn't get to public transport !
|
|
|
|
|
|
You need to Login to know who's really who.
You need to Login to know who's really who.
|
Well, on Friday I finally had hydrodilitation under fluoroscopy, after another consultant had said " we don't do it under ultrasound" , which the fracture clinic had sent me for.
Something did indeed seem to "pop" and discomfort level has decreased already.
However, the main ROM problem will probably not be fully resolved because the ultrasound guy found that I had a previously undiagnosed rotator cuff tear. Now to sort that out......
|
|
|
|
|
|
Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
|
I had a similar thing with my shoulder.
Physical Therapy helped me HUGELY! It really made a difference in the healing and recovery.
In the end, I had a separated tendon, bursitis and, a rotator cuff tear that could only be fixed by surgery. Physical Therapy made shoulder surgery go really smoothly with only minor discomfort post-surgery.
Take some Ibuprofen and do gentle movements unless it hurts. On Monday, talk to your primary care doctor about a Physical Therapy referral or, if that isn't an option a list of exercises to help you heal.
Also, I've read that increasing blood flow to the area can speed up recovery...massage, wrapping it and some gentle exercises/stretches, with shoulder exercise pulley but all have to be done in moderation and the right way. Otherwise, you risk more pain and prolonged recovery.
Here's a resource that I found on the internet about
https://www.atemi-sports.com/stretches-for-shoulder-pain/
|
|
|
|
|
|
You'll need to Register first of course.
You'll need to Register first of course.
|
|
|
|
|
|
Humorous ball split into 4, 9 pins in there holding it together.
After several weeks post operation, I got 1 hour session twice a week for 12 weeks I think.
That would have been expensive but luckily my work picked up the bill.
I also got several follow ups with surgeon & a procedure near end of physio that pumped air into joint that popped it open & eased the moment.
I have full movement now
|
|
|
|
|
|
|
|
FAQ
I do though agree with you about the importance of physiotherapy after sustaining a shoulder/rotator cuff injury. Back in 2006 I had a posterior dislocation of my right shoulder during a skiing fall. When I got back to the UK I saw a very good NHS physiotherapist who gave me a list of exercises to do during the different stages of my recovery, I worked very conscientously at them as I didn't want to get a frozen shoulder or reduced mobility, at the end of it I'd made a complete recovery with full mobility. 
